Childhood Communication Center

The Childhood Communication Center (CCC) provides care for children with hearing loss and speech problems. Our doctors, surgeons, geneticists, audiologists, speech and language pathologists and other specialists offer the most comprehensive range of pediatric hearing and speech services in the Pacific Northwest. We offer the only program in the region to evaluate voice disorders in children.

The center includes several programs and clinics, including the Cochlear Implant Program (PDF [Spanish]), Hearing Loss Clinic (PDF [Spanish]), Voice Clinic, VPD Clinic, Augmentative and Alternative Communication Program, Paradoxical Vocal Fold Movement Program and other services. Our care team identifies the causes of communication disorders and provides the most advanced therapies – including the latest hearing aid technology. The CCC works closely with the Washington Early Hearing Loss Detection Diagnosis and Intervention Program (EHDDI). We also offer ongoing support for children and their families.

Conditions We Treat

We diagnose and treat a wide variety of conditions that affect children’s hearing and speech, including:

Apraxia is a motor speech disorder in which the brain has problems planning to move the parts of the body (lips, jaw, tongue) used for speech. Children with apraxia know what they want to say, but their brain has difficulty coordinating the muscle movements needed to say the words.

Aural atresia is when a child is born without an ear canal. The inner ear and auditory nerve are usually normal, but the external ear and middle ear are typically malformed. Atresia can occur in one or both ears. A child with atresia in only one ear can also have hearing loss in the "normal" ear. Aural atresia is often associated with microtia (PDF) and craniofacial microsomia.

Delays or disorders of speech development can be caused by many things, including problems with breathing used to produce voice, problems with structures used in speaking (such as the lips or tongue) and/or problems with coordination of those structures. Delays or disorders of language development can be caused by problems hearing or understanding the language of other people, or by problems affecting parts of the brain responsible for learning and memory.

Hearing loss can occur for many reasons, including genetic causes, infection, trauma or damaging noise levels. If hearing loss goes undetected early in life, it can interfere with development of speech and language skills.

Hoarseness is the voice quality produced when something interferes with the normal vibration of the vocal folds. The most common cause of temporary (short-lived) hoarseness in children is swelling (inflammation) from a cold or flu. Hoarseness can be caused by nodules, polyps, cysts or other growths on the vocal cords. Children who strain their voices may also have hoarseness.

Microtia is a small or missing ear. Children with microtia are born with the condition. Some may have a small ear that has all of its internal parts. Others may be missing parts inside the ear. Read more. (PDF)

Paradoxical vocal fold movement (PVFM) is abnormal closure of the vocal folds (vocal cords). The vocal folds usually open while taking a breath and close while talking. In this condition, the vocal folds may work normally most of the time, but during a PVFM episode the vocal folds close when they should be open. Read more. (PDF)

In velopharyngeal dysfunction (VPD), parts of the throat and roof of the mouth do not work right during speech. When a child has VPD, their soft palate does not always contact their throat when they talk. This lets air escape through their nose during speech. If VPD is severe, it may be hard to understand your child’s speech. Read more.

Services We Offer

Audiology is the diagnosis and treatment of hearing loss. We are experts in identifying and evaluating hearing loss in newborns and young children, as well as in teens and young adults. We provide a full range of hearing tests, and offer complete rehabilitation services, including hearing aids and FM systems. Read more.

Augmentative and Alternative Communication (AAC) is all forms of communication except for oral speech. AAC aids, such as picture boards or electronic devices, can help children with serious speech or language problems express themselves. Read more.

Aural habilitation helps children with hearing problems improve their ability to use the sound that they can hear and express themselves in spoken language. At Seattle Children's, we offer many kinds of aural habilitation services. Read more. (PDF)

Cochlear implants are small, surgically implanted electronic devices that can help provide deaf or hard-of-hearing children with a sense of sound. They work by directly stimulating the hearing nerves with electrical signals. The cochlear implant team at Seattle Children’s Hospital provides a complete range of services, including:

Evaluating children to see whether they will benefit from an implant

Programming the device(s)

Ongoing care for children with implants

Auditory training to build spoken language skills for children with cochlear implants

Speech and language evaluations for children with cochlear implants

Psychosocial evaluations and support for children with cochlear implants

Hearing Loss Clinic brings together experts from a number of areas to assist children with hearing loss and their families, and to identify a cause of the hearing loss. Many families find Hearing Loss Clinic helpful after a new diagnosis of hearing loss, and during major transition periods for the child and/or family. Read more. (PDF)

Ear, nose and throat specialists (otolaryngologists) provide medical and surgical therapies to treat ear problems that cause hearing loss. They also work with audiologists and speech pathologists to evaluate and treat children with communication disorders. Read more.

The Psychiatry and Behavioral Medicine team at Children's provide therapy and treatment of behavioral and emotional concerns. We diagnose and treat mental health issues and coordinate care with educational, medical and other providers. We also provide a range of group settings such as a teen support group, interactive sign language class/support group for Spanish-speaking parents of DHH children and a variety of summer programs. Read more about mental health services for DHH children and their families (PDF).

Our Speech and Language team evaluates children and teens who have conditions that affect their ability to communicate. We assess your child's unique needs and develop short- and long-term treatment plans to ensure that you and your child find the services you need at school and in the community. Read more.

Our team of speech and language pathologists; ear, nose and throat specialists (otolaryngologists) and orthodontists assess and manage your child's speech problems associated with VPD. We work closely with the Craniofacial Center.

Our voice specialists and speech and language pathologists work together bringing years of clinical experience and expertise to each patient history and assessment. The examination may be enhanced by state-of-the-art videostroboscopy (an examination that uses video synchronized with a strobe light to detect problems with the function and motion of the vocal cords by watching them move in slow motion) in a friendly, informative clinic environment. By watching the exam on video as it occurs, patients and parents receive immediate information about their condition. The Voice Clinic team treats: Chronic hoarseness, raspiness, breathiness, weakness, dysphonia, vocal cord immobility or paralysis, paradoxical vocal cord movement, performance voice issues, or voice problems after airway trauma or surgery.

Paying for Care

Learn about paying for care at Seattle Children’s including insurance coverage, billing and financial assistance.

Remote Access

Seattle Children’s complies with applicable federal and other civil rights laws and does not discriminate, exclude people or treat them differently based on race, color, religion (creed), sex, gender identity or expression, sexual orientation, national origin (ancestry), age, disability, or any other status protected by applicable federal, state or local law. Financial assistance for medically necessary services is based on family income and hospital resources and is provided to children under age 21 whose primary residence is in Washington, Alaska, Montana or Idaho.

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